Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

CROSSRIDGE COMMUNITY HOSPITAL

Wynne, AR · CCN 041307 · Rates published

9,310 distinct procedures filed
17 distinct payers
278,423 rate rows
2025-06-11 last MRF observed · ⚠ 12 mo old
Data quality

128,434 of 278,423 rate rows are consumer-grade (46.1%)

149,989 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
professional (physician) fee — not the facility price 148,606
template filing: same amount across many unrelated codes — excluded 982
percent-of-charges filed in the dollar field — excluded from medians 274
per-diem day rate — not a per-procedure price 91
placeholder amount (≤ $0.02) — excluded from medians 25
exceeds 10× this hospital's gross charge — excluded from medians 11

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 12 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8119/710835247_st-bernards-community-hospital-corporation_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/St.BernardsHealthcareCrossRidgeCommunityHospital/8119
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 6343474ee3e080f6… · 93,809,319 bytes · first seen 2026-05-08

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
Q2056
HCPCS 		Ciltacabtagene Car-pos T 2 $1,203,327.00 $1,224,531.00 $1,213,929.00 nat. median
$675,122
1.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 2 $1,085,582.10 $1,104,711.30 $1,095,146.70 nat. median
$625,184
1.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $1,061,774.34 $1,080,484.02 $1,071,129.18 nat. median
$674,188
1.6× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $1,032,532.20 $1,050,726.60 $1,041,629.40 nat. median
$620,080
1.7× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $1,032,532.20 $1,050,726.60 $1,041,629.40 nat. median
$634,511
1.6× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $304,244.24 $304,244.24 $304,244.24 nat. median
$370,174
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 3 $143,292.00 $227,244.94 $227,244.94 nat. median
$265,286
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 $76,286.00 $191,381.32 $191,381.32 nat. median
$206,368
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 3 $116,378.00 $172,897.29 $172,897.29 nat. median
$202,986
0.9× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 2 $155,268.00 $158,004.00 $156,636.00 nat. median
$69,774
outlier · 2.2×
C9150
HCPCS 		Fee Schedule 2 $134,565.60 $136,936.80 $135,751.20 nat. median
$775
outlier · 175.2×
0100T
CPT 		Prosth Retina Receive&gen 2 $125,818.00 $132,440.00 $129,129.00 nat. median
$11,210
outlier · 11.5×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 3 $70,816.00 $113,992.36 $113,992.36 nat. median
$133,176
0.9× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 2 $105,697.46 $105,697.46 $105,697.46 nat. median
$117,303
0.9× median
7
MS_DRG 		Lung Transplant 3 $52,081.00 $105,431.24 $105,431.24 nat. median
$122,708
0.9× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 $88,900.33 $100,896.00 $88,900.33 nat. median
$108,660
0.8× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 2 $87,885.45 $87,885.45 $87,885.45 nat. median
$102,358
0.9× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 3 $65,794.00 $85,912.97 $85,912.97 nat. median
$100,136
0.9× median
215
MS_DRG 		Other Heart Assist System Implant 3 $74,410.00 $85,472.49 $85,472.49 nat. median
$99,019
0.9× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $84,509.24 $84,509.24 $84,509.24 nat. median
$98,905
0.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 $57,685.00 $77,859.28 $77,859.28 nat. median
$93,672
0.8× median
850
MS_DRG 		Acute Leukemia With Other Procedures 2 $74,316.08 $74,316.08 $74,316.08 nat. median
$83,442
0.9× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 3 $45,256.00 $68,362.34 $68,362.34 nat. median
$79,312
0.9× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 $41,955.00 $68,324.42 $68,324.42 nat. median
$81,118
0.8× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 $67,286.96 $67,286.96 $67,286.96 nat. median
$82,712
0.8× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 $47,785.00 $65,032.12 $65,032.12 nat. median
$77,576
0.8× median
10
MS_DRG 		Pancreas Transplant 3 $24,119.00 $64,321.38 $64,321.38 nat. median
$68,882
0.9× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 $63,952.70 $63,952.70 $63,952.70 nat. median
$71,240
0.9× median
J9359
HCPCS 		Zynlonta 10mg Vial 17 $424.10 $72,771.87 $63,675.39 nat. median
$701
outlier · 90.9×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 3 $39,987.00 $63,058.03 $63,058.03 nat. median
$73,807
0.9× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 $44,685.00 $62,421.51 $62,421.51 nat. median
$74,915
0.8× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 $35,935.00 $60,216.69 $60,216.69 nat. median
$72,138
0.8× median
J9281
HCPCS 		Jelmyto 80mg Kit 17 $640.53 $66,319.50 $58,029.57 nat. median
$545
outlier · 106.5×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $57,300.32 $57,300.32 $57,300.32 nat. median
$68,090
0.8× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 $57,012.32 $57,012.32 $57,012.32 nat. median
$68,887
0.8× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 3 $35,699.00 $56,120.87 $56,120.87 nat. median
$66,526
0.8× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 3 $31,637.00 $55,086.63 $55,086.63 nat. median
$64,732
0.9× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 $54,089.50 $54,089.50 $54,089.50 nat. median
$63,738
0.8× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 3 $27,253.00 $53,881.36 $53,881.36 nat. median
$64,027
0.8× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 $53,790.20 $53,790.20 $53,790.20 nat. median
$65,950
0.8× median
453
MS_DRG 		DRG 1 $52,274.00 $52,274.00 $52,274.00 nat. median
$87,411
0.6× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 3 $31,763.00 $52,173.49 $52,173.49 nat. median
$62,134
0.8× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 $47,004.00 $52,098.46 $52,098.46 nat. median
$64,510
0.8× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 3 $31,865.00 $51,020.66 $51,020.66 nat. median
$60,185
0.8× median
64568
CPT 		Opn Impltj Crnl Nrv Nea&pg 4 $30,226.11 $69,446.64 $50,030.53 nat. median
$27,541
1.8× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 2 $49,972.70 $49,972.70 $49,972.70 nat. median
$59,099
0.8× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 2 $49,908.16 $49,908.16 $49,908.16 nat. median
$60,691
0.8× median
222
MS_DRG 		DRG 1 $49,745.00 $49,745.00 $49,745.00 nat. median
$63,570
0.8× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 $17,039.00 $49,680.66 $49,680.66 nat. median
$59,793
0.8× median
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 3 $23,774.00 $49,507.21 $49,507.21 nat. median
$55,736
0.9× median

Other procedures at this hospital

Browse this hospital's 9,310 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 3 3 — — $14,629.00 $18,217.80 $18,217.80 2025-06-11
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 3 3 — — $9,486.00 $18,218.61 $18,218.61 2025-06-11
53445 CPT Insert Uro/ves Nck Sphincter 3 3 — — $850.00 $19,202.40 $18,242.28 2025-06-11
54401 CPT Insert Self-contd Prosthesis 3 3 — — $1,600.00 $19,202.40 $18,242.28 2025-06-11
54405 CPT Insert Multi-comp Penis Pros 3 3 — — $1,600.00 $19,202.40 $18,242.28 2025-06-11
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 3 3 — — $10,506.00 $18,280.73 $18,280.73 2025-06-11
35 MS_DRG Carotid Artery Stent Procedures With Cc 3 3 — — $11,777.00 $18,351.72 $18,351.72 2025-06-11
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 3 3 — — $13,626.00 $18,385.60 $18,385.60 2025-06-11
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 3 3 — — $18,420.29 $18,665.00 $18,420.29 2025-06-11
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 3 3 — — $10,026.00 $18,476.77 $18,476.77 2025-06-11
33902 CPT Perq P-art Revsc 1 Abnor Uni 2 2 — — $18,007.68 $18,955.45 $18,481.57 2025-06-11
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 3 3 — — $10,995.00 $18,507.42 $18,507.42 2025-06-11
J9301 HCPCS Gazyva Vl 1000mg 40ml 32 17 $21,224.34 $13,795.82 35% off $123.12 $21,224.34 $18,571.29 2025-06-11
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 3 3 — — $13,035.00 $18,622.79 $18,622.79 2025-06-11
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 3 3 — — $15,419.00 $18,656.67 $18,656.67 2025-06-11
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 2 2 — — $18,674.42 $18,674.42 $18,674.42 2025-06-11
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 3 3 — — $10,369.00 $18,717.98 $18,717.98 2025-06-11
54411 CPT Remov/replc Penis Pros Comp 2 2 — — $18,242.28 $19,202.40 $18,722.34 2025-06-11
54410 CPT Remove/replace Penis Prosth 2 2 — — $18,242.28 $19,202.40 $18,722.34 2025-06-11
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 3 3 — — $12,298.00 $18,866.42 $18,866.42 2025-06-11
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 3 — — $15,023.00 $19,038.26 $19,038.26 2025-06-11
330 MS_DRG Major Small And Large Bowel Procedures With Cc 3 3 — — $17,940.00 $19,068.91 $19,068.91 2025-06-11
347 MS_DRG Anal And Stomal Procedures With Mcc 3 3 — — $10,948.00 $19,093.92 $19,093.92 2025-06-11
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 3 3 — — $12,056.00 $19,098.76 $19,098.76 2025-06-11
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 3 3 — — $13,244.00 $19,172.18 $19,172.18 2025-06-11
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 3 3 — — $14,559.00 $19,339.17 $19,339.17 2025-06-11
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 3 3 — — $15,921.00 $19,339.17 $19,339.17 2025-06-11
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 3 3 — — $10,655.00 $19,369.83 $19,369.83 2025-06-11
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 3 3 — — $9,497.00 $19,451.31 $19,451.31 2025-06-11
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 3 3 — — $11,365.00 $19,512.62 $19,512.62 2025-06-11
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 3 3 — — $19,588.45 $20,423.00 $19,588.45 2025-06-11
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 3 3 — — $19,751.42 $21,958.00 $19,751.42 2025-06-11
792 MS_DRG Prematurity Without Major Problems 3 3 — — $12,006.00 $19,762.71 $19,762.71 2025-06-11
238 MS_DRG DRG 1 1 — — $19,773.00 $19,773.00 $19,773.00 2025-06-11
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 3 3 — — $14,420.00 $19,908.73 $19,908.73 2025-06-11
397 MS_DRG Appendix Procedures With Mcc 2 2 — — $19,989.40 $19,989.40 $19,989.40 2025-06-11
64575 CPT Opn Impltj Nea Perph Nerve 3 3 — — $850.00 $21,066.08 $20,012.78 2025-06-11
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 2 2 — — $20,186.25 $20,186.25 $20,186.25 2025-06-11
56 MS_DRG Degenerative Nervous System Disorders With Mcc 3 3 — — $7,949.00 $20,201.58 $20,201.58 2025-06-11
J1300 HCPCS Soliris 300mg/30ml 32 17 $23,102.00 $15,016.30 35% off $400.38 $23,102.00 $20,214.25 2025-06-11
164 MS_DRG Major Chest Procedures With Cc 3 3 — — $17,410.00 $20,305.65 $20,305.65 2025-06-11
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 3 3 — — $10,889.00 $20,369.38 $20,369.38 2025-06-11
545 MS_DRG Connective Tissue Disorders With Mcc 3 3 — — $11,365.00 $20,385.51 $20,385.51 2025-06-11
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 2 2 — — $20,451.67 $20,451.67 $20,451.67 2025-06-11
0426T CPT Apc 2 2 — — $20,012.78 $21,066.08 $20,539.43 2025-06-11
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 3 3 — — $12,341.00 $20,557.35 $20,557.35 2025-06-11
253 MS_DRG Other Vascular Procedures With Cc 3 3 — — $13,972.00 $20,596.07 $20,596.07 2025-06-11
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 3 3 — — $10,244.00 $20,602.53 $20,602.53 2025-06-11
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 3 3 — — $17,434.00 $20,848.58 $20,848.58 2025-06-11
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 3 3 — — $14,144.00 $20,883.27 $20,883.27 2025-06-11
61885 CPT Insrt/redo Neurostim 1 Array 5 5 — — $1,250.00 $48,307.99 $21,066.08 2025-06-11
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 3 3 — — $13,321.00 $21,108.35 $21,108.35 2025-06-11
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 3 3 — — $15,218.00 $21,163.21 $21,163.21 2025-06-11
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 3 3 — — $21,329.40 $22,932.00 $21,329.40 2025-06-11
503 MS_DRG Foot Procedures With Mcc 3 3 — — $10,874.00 $21,351.18 $21,351.18 2025-06-11
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 3 3 — — $16,591.00 $21,378.61 $21,378.61 2025-06-11
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 3 3 — — $21,405.23 $22,847.00 $21,405.23 2025-06-11
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 3 3 — — $10,082.00 $21,481.87 $21,481.87 2025-06-11
849 MS_DRG Radiotherapy 3 3 — — $7,851.00 $21,548.83 $21,548.83 2025-06-11
460 MS_DRG DRG 1 1 — — $21,619.00 $21,619.00 $21,619.00 2025-06-11
263 MS_DRG Vein Ligation And Stripping 3 3 — — $9,286.00 $21,637.57 $21,637.57 2025-06-11
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 3 3 — — $13,927.00 $21,651.29 $21,651.29 2025-06-11
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 3 3 — — $15,597.00 $21,737.61 $21,737.61 2025-06-11
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 3 3 — — $15,835.00 $21,809.41 $21,809.41 2025-06-11
963 MS_DRG Other Multiple Significant Trauma With Mcc 3 3 — — $14,251.00 $21,916.71 $21,916.71 2025-06-11
619 MS_DRG O.r. Procedures For Obesity With Mcc 3 3 — — $17,128.00 $21,995.77 $21,995.77 2025-06-11
0308T CPT Insj Ocular Telescope Prosth 2 2 — — $21,461.94 $22,591.52 $22,026.73 2025-06-11
288 MS_DRG Acute And Subacute Endocarditis With Mcc 3 3 — — $18,069.00 $22,036.10 $22,036.10 2025-06-11
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 3 3 — — $21,159.00 $22,075.63 $22,075.63 2025-06-11
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 3 3 — — $14,214.00 $22,633.09 $22,633.09 2025-06-11
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 3 3 — — $20,553.00 $22,656.49 $22,656.49 2025-06-11
654 MS_DRG Major Bladder Procedures With Cc 3 3 — — $19,753.00 $22,767.01 $22,767.01 2025-06-11
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 2 2 — — $22,966.27 $22,966.27 $22,966.27 2025-06-11
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 3 3 — — $10,302.00 $23,057.44 $23,057.44 2025-06-11
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 2 2 — — $23,089.71 $23,089.71 $23,089.71 2025-06-11
J7169 HCPCS Andexxa 200mg 32 17 $26,400.00 $17,160.00 35% off $661.71 $26,400.00 $23,100.00 2025-06-11
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 3 3 — — $19,216.00 $23,103.42 $23,103.42 2025-06-11
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 3 3 — — $9,875.00 $23,130.04 $23,130.04 2025-06-11
472 MS_DRG Cervical Spinal Fusion With Cc 3 3 — — $15,388.00 $23,372.87 $23,372.87 2025-06-11
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 3 3 — — $18,589.00 $23,493.88 $23,493.88 2025-06-11
800 MS_DRG Splenic Procedures With Cc 3 3 — — $17,123.00 $23,506.79 $23,506.79 2025-06-11
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 2 2 — — $23,514.05 $23,514.05 $23,514.05 2025-06-11
668 MS_DRG Transurethral Procedures With Mcc 3 3 — — $10,669.00 $23,526.96 $23,526.96 2025-06-11
J2327 HCPCS Risankizumab-rzaa 600mg/10ml 32 17 $26,977.39 $17,535.30 35% off $35.89 $26,977.39 $23,605.22 2025-06-11
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 3 3 — — $12,549.00 $23,661.68 $23,661.68 2025-06-11
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 3 3 — — $14,897.00 $23,726.22 $23,726.22 2025-06-11
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 3 — — $17,869.00 $23,787.54 $23,787.54 2025-06-11
974 MS_DRG HIV With Major Related Condition With Mcc 3 3 — — $13,257.00 $24,090.87 $24,090.87 2025-06-11
0520T CPT Rmv&rplcmt Pg Wcs Lv Battery 2 2 — — $23,576.11 $24,816.96 $24,196.53 2025-06-11
0515T CPT Insj Wcs Lv Compl Sys 2 2 — — $23,576.11 $24,816.96 $24,196.53 2025-06-11
0414T CPT Rmvl & Rpl Car Modulj Pls Gn 2 2 — — $23,576.11 $24,816.96 $24,196.53 2025-06-11
0409T CPT Insj/rplc Car Modulj Pls Gn 2 2 — — $23,576.11 $24,816.96 $24,196.53 2025-06-11
0408T CPT Insj/rplc Cardiac Modulj Sys 2 2 — — $23,576.11 $24,816.96 $24,196.53 2025-06-11
570 MS_DRG Skin Debridement With Mcc 2 2 — — $24,284.49 $24,284.49 $24,284.49 2025-06-11
J3357 HCPCS Stelara 45mg/0.5ml 47 17 $28,009.00 $18,205.85 35% off $257.42 $57,642.00 $24,507.88 2025-06-11
27412 CPT Autochondrocyte Implant Knee 4 4 — — $824.01 $51,055.57 $24,670.66 2025-06-11
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 3 3 — — $19,581.00 $24,674.95 $24,674.95 2025-06-11
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 2 2 — — $24,755.62 $24,755.62 $24,755.62 2025-06-11
652 MS_DRG Kidney Transplant 3 3 — — $19,005.00 $24,778.21 $24,778.21 2025-06-11
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 3 3 — — $15,434.00 $24,878.25 $24,878.25 2025-06-11
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 2 2 — — $24,896.00 $24,896.00 $24,896.00 2025-06-11
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 3 3 — — $15,412.00 $24,947.63 $24,947.63 2025-06-11
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 3 3 — — $25,059.76 $32,978.00 $25,059.76 2025-06-11
662 MS_DRG Minor Bladder Procedures With Mcc 3 3 — — $12,632.00 $25,167.06 $25,167.06 2025-06-11
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 2 2 — — $25,178.36 $25,178.36 $25,178.36 2025-06-11
500 MS_DRG Soft Tissue Procedures With Mcc 3 3 — — $14,939.00 $25,563.17 $25,563.17 2025-06-11
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 3 3 — — $13,436.00 $25,605.93 $25,605.93 2025-06-11
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 3 3 — — $14,590.00 $25,657.56 $25,657.56 2025-06-11
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 3 3 — — $13,302.00 $25,726.94 $25,726.94 2025-06-11
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 2 2 — — $25,776.15 $25,776.15 $25,776.15 2025-06-11
C9163 HCPCS Talvey 40mg/1ml 30 17 $29,526.00 $19,191.90 35% off $14,910.63 $29,526.00 $25,835.25 2025-06-11
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 2 — — $25,851.18 $25,851.18 $25,851.18 2025-06-11
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 3 3 — — $18,204.00 $25,971.38 $25,971.38 2025-06-11
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 3 3 — — $16,494.00 $26,283.59 $26,283.59 2025-06-11
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 3 3 — — $14,318.00 $26,294.88 $26,294.88 2025-06-11
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 3 3 — — $16,532.00 $26,369.91 $26,369.91 2025-06-11
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 2 2 — — $26,637.75 $26,637.75 $26,637.75 2025-06-11
37 MS_DRG Extracranial Procedures With Mcc 3 3 — — $14,030.00 $26,791.03 $26,791.03 2025-06-11
J9333 HCPCS Rystiggo 560 Mg Vial 60 17 $34,350.51 $22,327.83 35% off $8,695.27 $51,525.78 $27,051.03 2025-06-11
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 3 3 — — $17,581.00 $27,079.84 $27,079.84 2025-06-11
J9272 HCPCS Jemperli 50mg/ml Vial 32 17 $31,088.53 $20,207.54 35% off $488.32 $31,088.53 $27,202.46 2025-06-11
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 3 3 — — $20,203.00 $27,364.62 $27,364.62 2025-06-11
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 3 3 — — $13,408.00 $27,479.18 $27,479.18 2025-06-11
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 3 3 — — $17,064.00 $27,632.46 $27,632.46 2025-06-11
252 MS_DRG Other Vascular Procedures With Mcc 3 3 — — $17,089.00 $27,674.41 $27,674.41 2025-06-11
665 MS_DRG Prostatectomy With Mcc 3 3 — — $13,264.00 $27,700.22 $27,700.22 2025-06-11
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 3 3 — — $16,464.00 $27,743.79 $27,743.79 2025-06-11
271 MS_DRG Other Major Cardiovascular Procedures With Cc 2 2 — — $27,787.35 $27,787.35 $27,787.35 2025-06-11
237 MS_DRG DRG 1 1 — — $27,872.00 $27,872.00 $27,872.00 2025-06-11
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 3 3 — — $12,510.00 $27,952.73 $27,952.73 2025-06-11
332 MS_DRG Rectal Resection With Mcc 3 3 — — $23,026.00 $27,983.39 $27,983.39 2025-06-11
J2507 HCPCS Krystexxa 8mg/ml 32 17 $31,998.26 $20,798.87 35% off $685.84 $31,998.26 $27,998.48 2025-06-11
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 2 2 — — $28,014.05 $28,014.05 $28,014.05 2025-06-11
264 MS_DRG Other Circulatory System O.r. Procedures 3 3 — — $15,401.00 $28,196.37 $28,196.37 2025-06-11
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 3 — — $23,895.00 $28,246.39 $28,246.39 2025-06-11
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 — — $17,670.00 $28,257.68 $28,257.68 2025-06-11
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 3 3 — — $19,184.00 $28,266.56 $28,266.56 2025-06-11
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 3 — — $15,974.00 $28,402.09 $28,402.09 2025-06-11
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 3 — — $21,608.00 $28,473.89 $28,473.89 2025-06-11
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 3 3 — — $28,481.15 $34,773.00 $28,481.15 2025-06-11
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 3 3 — — $13,896.00 $28,648.95 $28,648.95 2025-06-11
265 MS_DRG Aicd Lead Procedures 2 2 — — $28,778.03 $28,778.03 $28,778.03 2025-06-11
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 3 3 — — $12,376.00 $28,913.56 $28,913.56 2025-06-11
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 3 3 — — $16,532.00 $28,918.40 $28,918.40 2025-06-11
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 3 3 — — $17,323.00 $28,920.02 $28,920.02 2025-06-11
335 MS_DRG Peritoneal Adhesiolysis With Mcc 3 3 — — $21,566.00 $29,231.42 $29,231.42 2025-06-11
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 3 — — $19,529.00 $29,435.52 $29,435.52 2025-06-11
230 MS_DRG DRG 1 1 — — $29,665.00 $29,665.00 $29,665.00 2025-06-11
459 MS_DRG DRG 1 1 — — $30,181.00 $30,181.00 $30,181.00 2025-06-11
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 3 3 — — $16,899.00 $30,188.21 $30,188.21 2025-06-11
61886 CPT Implant Neurostim Arrays 3 3 — — $1,400.00 $31,816.96 $30,226.11 2025-06-11
33289 CPT Tcat Impl Wrls P-art Prs Snr 2 2 — — $29,605.80 $31,164.00 $30,384.90 2025-06-11
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 3 3 — — $20,181.00 $30,431.04 $30,431.04 2025-06-11
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 — — $24,166.00 $30,669.83 $30,669.83 2025-06-11
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 3 — — $21,609.00 $30,836.83 $30,836.83 2025-06-11
0268T CPT Implt/rpl Crtd Sns Dev Gen 2 2 — — $30,226.11 $31,816.96 $31,021.53 2025-06-11
0431T CPT Apc 2 2 — — $30,226.11 $31,816.96 $31,021.53 2025-06-11
0427T CPT Apc 2 2 — — $30,226.11 $31,816.96 $31,021.53 2025-06-11
0424T CPT Apc 2 2 — — $30,226.11 $31,816.96 $31,021.53 2025-06-11
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 3 3 — — $20,260.00 $31,061.91 $31,061.91 2025-06-11
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 3 3 — — $15,652.00 $31,149.04 $31,149.04 2025-06-11
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 3 3 — — $19,498.00 $31,180.50 $31,180.50 2025-06-11
227 MS_DRG DRG 1 1 — — $31,255.00 $31,255.00 $31,255.00 2025-06-11
34 MS_DRG Carotid Artery Stent Procedures With Mcc 3 3 — — $15,771.00 $31,371.70 $31,371.70 2025-06-11
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 2 2 — — $31,545.95 $31,545.95 $31,545.95 2025-06-11
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $31,561.28 $31,561.28 $31,561.28 2025-06-11
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 3 3 — — $15,272.00 $31,701.66 $31,701.66 2025-06-11
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 3 3 — — $19,907.00 $31,766.19 $31,766.19 2025-06-11
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 3 3 — — $18,973.00 $31,831.54 $31,831.54 2025-06-11
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 3 3 — — $13,690.00 $32,115.51 $32,115.51 2025-06-11
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 3 3 — — $19,239.00 $32,138.10 $32,138.10 2025-06-11
791 MS_DRG Prematurity With Major Problems 3 3 — — $19,897.00 $32,752.84 $32,752.84 2025-06-11
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 3 — — $24,548.00 $32,813.34 $32,813.34 2025-06-11
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 2 2 — — $32,943.23 $32,943.23 $32,943.23 2025-06-11
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 3 3 — — $20,133.00 $33,106.19 $33,106.19 2025-06-11
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 3 — — $27,767.00 $33,155.40 $33,155.40 2025-06-11
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 3 3 — — $23,130.00 $33,173.96 $33,173.96 2025-06-11
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 2 2 — — $33,566.03 $33,566.03 $33,566.03 2025-06-11
793 MS_DRG Full Term Neonate With Major Problems 3 3 — — $20,439.00 $33,645.09 $33,645.09 2025-06-11
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 3 — — $15,646.00 $33,799.18 $33,799.18 2025-06-11
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 3 — — $19,980.00 $33,807.25 $33,807.25 2025-06-11
J9226 HCPCS Supprelin La Implant 2 2 — — $33,673.32 $34,266.68 $33,970.00 2025-06-11
140 MS_DRG Major Head And Neck Procedures With Mcc 2 2 — — $34,118.65 $34,118.65 $34,118.65 2025-06-11
J0223 HCPCS Givlaari 189mg/ml 32 17 $39,000.00 $25,350.00 35% off $243.30 $39,000.00 $34,125.00 2025-06-11
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 2 2 — — $34,362.28 $34,362.28 $34,362.28 2025-06-11
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 3 — — $20,950.00 $34,413.11 $34,413.11 2025-06-11
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $30,651.00 $34,835.03 $34,835.03 2025-06-11
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 3 3 — — $16,508.00 $34,906.83 $34,906.83 2025-06-11
455 MS_DRG DRG 1 1 — — $35,354.00 $35,354.00 $35,354.00 2025-06-11
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 2 2 — — $35,438.47 $35,438.47 $35,438.47 2025-06-11
901 MS_DRG Wound Debridements For Injuries With Mcc 3 3 — — $17,691.00 $35,742.62 $35,742.62 2025-06-11
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 3 — — $26,264.00 $36,079.83 $36,079.83 2025-06-11
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 3 3 — — $17,628.00 $36,179.87 $36,179.87 2025-06-11
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 3 3 — — $24,339.00 $36,396.88 $36,396.88 2025-06-11
226 MS_DRG DRG 1 1 — — $36,657.00 $36,657.00 $36,657.00 2025-06-11
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 3 — — $27,936.00 $37,044.69 $37,044.69 2025-06-11
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $32,527.00 $37,050.34 $37,050.34 2025-06-11
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 2 2 — — $37,168.93 $37,168.93 $37,168.93 2025-06-11
163 MS_DRG Major Chest Procedures With Mcc 3 3 — — $25,080.00 $37,184.26 $37,184.26 2025-06-11
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 2 2 — — $37,528.74 $37,528.74 $37,528.74 2025-06-11
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 3 — — $21,817.00 $37,751.40 $37,751.40 2025-06-11
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 2 2 — — $37,954.70 $37,954.70 $37,954.70 2025-06-11
J7330 HCPCS Cultured Chondrocytes Implnt 2 2 — — $37,649.52 $38,312.94 $37,981.23 2025-06-11
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 — — $28,004.00 $38,351.61 $38,351.61 2025-06-11
799 MS_DRG Splenic Procedures With Mcc 3 3 — — $24,498.00 $38,358.87 $38,358.87 2025-06-11
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 3 — — $24,664.00 $38,525.87 $38,525.87 2025-06-11
225 MS_DRG DRG 1 1 — — $39,033.00 $39,033.00 $39,033.00 2025-06-11
6 MS_DRG Liver Transplant Without Mcc 3 3 — — $39,120.44 $44,988.00 $39,120.44 2025-06-11
471 MS_DRG Cervical Spinal Fusion With Mcc 3 3 — — $21,528.00 $39,185.78 $39,185.78 2025-06-11
J9334 HCPCS Vyvgrt Hytrl 1008mg 11200un Vl 30 17 $44,953.00 $29,219.45 35% off $22,701.27 $44,953.00 $39,333.88 2025-06-11
245 MS_DRG Aicd Generator Procedures 3 3 — — $19,266.00 $39,423.77 $39,423.77 2025-06-11
9 MS_DRG DRG 1 1 — — $40,202.00 $40,202.00 $40,202.00 2025-06-11
228 MS_DRG Other Cardiothoracic Procedures With Mcc 3 3 — — $40,202.27 $41,788.00 $40,202.27 2025-06-11
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 3 — — $32,141.00 $40,347.49 $40,347.49 2025-06-11
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 2 — — $40,363.62 $40,363.62 $40,363.62 2025-06-11
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 3 3 — — $29,628.00 $40,395.09 $40,395.09 2025-06-11
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 3 — — $24,461.00 $40,634.69 $40,634.69 2025-06-11
454 MS_DRG DRG 1 1 — — $40,802.00 $40,802.00 $40,802.00 2025-06-11
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 3 3 — — $32,029.00 $40,974.32 $40,974.32 2025-06-11
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 3 3 — — $21,953.00 $41,100.18 $41,100.18 2025-06-11
Q2043 HCPCS Sipuleucel-t Min 50million 32 17 $47,001.00 $30,550.65 35% off $23,735.51 $122,237.12 $41,125.88 2025-06-11
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 2 2 — — $41,409.96 $41,409.96 $41,409.96 2025-06-11
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 2 2 — — $41,547.92 $41,547.92 $41,547.92 2025-06-11
J2350 HCPCS Ocrevus Sdv 30mg/ml 32 17 $48,750.00 $31,687.50 35% off $129.57 $48,750.00 $42,656.25 2025-06-11
223 MS_DRG DRG 1 1 — — $42,661.00 $42,661.00 $42,661.00 2025-06-11
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $35,512.00 $42,730.60 $42,730.60 2025-06-11
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 3 3 — — $30,514.00 $42,920.18 $42,920.18 2025-06-11
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $15,355.00 $43,526.04 $43,526.04 2025-06-11
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 3 3 — — $25,719.00 $43,530.88 $43,530.88 2025-06-11
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 3 — — $24,561.00 $43,572.03 $43,572.03 2025-06-11
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 3 3 — — $29,930.00 $43,795.49 $43,795.49 2025-06-11
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 3 3 — — $32,070.00 $43,895.53 $43,895.53 2025-06-11
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 2 2 — — $44,132.71 $44,132.71 $44,132.71 2025-06-11
J7311 HCPCS Inj., Retisert, 0.01 Mg 2 2 — — $43,913.15 $44,686.95 $44,300.05 2025-06-11
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 — — $44,403.78 $44,403.78 $44,403.78 2025-06-11
834 MS_DRG Acute Leukemia With Mcc 3 3 — — $22,544.00 $44,590.94 $44,590.94 2025-06-11
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 3 — — $41,553.00 $44,590.94 $44,590.94 2025-06-11
653 MS_DRG Major Bladder Procedures With Mcc 3 3 — — $28,340.00 $44,972.53 $44,972.53 2025-06-11
224 MS_DRG DRG 1 1 — — $45,370.00 $45,370.00 $45,370.00 2025-06-11
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 — — $29,162.00 $46,025.32 $46,025.32 2025-06-11
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $33,883.00 $46,302.04 $46,302.04 2025-06-11
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 3 — — $27,881.00 $46,970.82 $46,970.82 2025-06-11
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 3 3 — — $31,856.00 $47,470.20 $47,470.20 2025-06-11
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 3 3 — — $29,134.00 $47,959.08 $47,959.08 2025-06-11
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $42,529.00 $47,995.38 $47,995.38 2025-06-11
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 2 2 — — $48,330.18 $48,330.18 $48,330.18 2025-06-11
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 2 2 — — $48,694.02 $48,694.02 $48,694.02 2025-06-11
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 2 2 — — $48,694.02 $48,694.02 $48,694.02 2025-06-11
28 MS_DRG Spinal Procedures With Mcc 3 3 — — $26,250.00 $49,045.76 $49,045.76 2025-06-11
232 MS_DRG Coronary Bypass With Ptca Without Mcc 3 3 — — $38,407.00 $49,281.33 $49,281.33 2025-06-11
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 3 3 — — $23,774.00 $49,507.21 $49,507.21 2025-06-11
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $17,039.00 $49,680.66 $49,680.66 2025-06-11
222 MS_DRG DRG 1 1 — — $49,745.00 $49,745.00 $49,745.00 2025-06-11
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 2 2 — — $49,908.16 $49,908.16 $49,908.16 2025-06-11
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 2 2 — — $49,972.70 $49,972.70 $49,972.70 2025-06-11
64568 CPT Opn Impltj Crnl Nrv Nea&pg 4 4 — — $30,226.11 $69,446.64 $50,030.53 2025-06-11
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 3 3 — — $31,865.00 $51,020.66 $51,020.66 2025-06-11
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $47,004.00 $52,098.46 $52,098.46 2025-06-11
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 3 3 — — $31,763.00 $52,173.49 $52,173.49 2025-06-11
453 MS_DRG DRG 1 1 — — $52,274.00 $52,274.00 $52,274.00 2025-06-11
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 2 — — $53,790.20 $53,790.20 $53,790.20 2025-06-11
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 3 3 — — $27,253.00 $53,881.36 $53,881.36 2025-06-11
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 2 — — $54,089.50 $54,089.50 $54,089.50 2025-06-11
955 MS_DRG Craniotomy For Multiple Significant Trauma 3 3 — — $31,637.00 $55,086.63 $55,086.63 2025-06-11
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 3 3 — — $35,699.00 $56,120.87 $56,120.87 2025-06-11
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 2 — — $57,012.32 $57,012.32 $57,012.32 2025-06-11
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 — — $57,300.32 $57,300.32 $57,300.32 2025-06-11
J9281 HCPCS Jelmyto 80mg Kit 32 17 $66,319.50 $43,107.68 35% off $640.53 $66,319.50 $58,029.57 2025-06-11
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 3 — — $35,935.00 $60,216.69 $60,216.69 2025-06-11
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $44,685.00 $62,421.51 $62,421.51 2025-06-11
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 3 3 — — $39,987.00 $63,058.03 $63,058.03 2025-06-11
J9359 HCPCS Zynlonta 10mg Vial 32 17 $72,771.87 $47,301.72 35% off $424.10 $72,771.87 $63,675.39 2025-06-11
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 2 — — $63,952.70 $63,952.70 $63,952.70 2025-06-11
10 MS_DRG Pancreas Transplant 3 3 — — $24,119.00 $64,321.38 $64,321.38 2025-06-11
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 3 — — $47,785.00 $65,032.12 $65,032.12 2025-06-11
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 2 — — $67,286.96 $67,286.96 $67,286.96 2025-06-11
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $41,955.00 $68,324.42 $68,324.42 2025-06-11
231 MS_DRG Coronary Bypass With Ptca With Mcc 3 3 — — $45,256.00 $68,362.34 $68,362.34 2025-06-11
850 MS_DRG Acute Leukemia With Other Procedures 2 2 — — $74,316.08 $74,316.08 $74,316.08 2025-06-11
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $57,685.00 $77,859.28 $77,859.28 2025-06-11
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 — — $84,509.24 $84,509.24 $84,509.24 2025-06-11
215 MS_DRG Other Heart Assist System Implant 3 3 — — $74,410.00 $85,472.49 $85,472.49 2025-06-11
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 3 3 — — $65,794.00 $85,912.97 $85,912.97 2025-06-11
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 2 2 — — $87,885.45 $87,885.45 $87,885.45 2025-06-11
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 3 — — $88,900.33 $100,896.00 $88,900.33 2025-06-11
7 MS_DRG Lung Transplant 3 3 — — $52,081.00 $105,431.24 $105,431.24 2025-06-11
14 MS_DRG Allogeneic Bone Marrow Transplant 2 2 — — $105,697.46 $105,697.46 $105,697.46 2025-06-11
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 3 3 — — $70,816.00 $113,992.36 $113,992.36 2025-06-11
0100T CPT Prosth Retina Receive&gen 2 2 — — $125,818.00 $132,440.00 $129,129.00 2025-06-11
C9150 HCPCS Fee Schedule 2 2 — — $134,565.60 $136,936.80 $135,751.20 2025-06-11
J9029 HCPCS Instill Adstiladrin, Tx Dose 2 2 — — $155,268.00 $158,004.00 $156,636.00 2025-06-11
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 3 3 — — $116,378.00 $172,897.29 $172,897.29 2025-06-11
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 3 — — $76,286.00 $191,381.32 $191,381.32 2025-06-11
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 3 3 — — $143,292.00 $227,244.94 $227,244.94 2025-06-11
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $304,244.24 $304,244.24 $304,244.24 2025-06-11
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 2 2 — — $1,032,532.20 $1,050,726.60 $1,041,629.40 2025-06-11
Q2053 HCPCS Brexucabtagene Car Pos T 2 2 — — $1,032,532.20 $1,050,726.60 $1,041,629.40 2025-06-11
Q2054 HCPCS Lisocabtagene Mara Car Pos T 2 2 — — $1,061,774.34 $1,080,484.02 $1,071,129.18 2025-06-11
Q2055 HCPCS Idecabtagene Vicleucel Car 2 2 — — $1,085,582.10 $1,104,711.30 $1,095,146.70 2025-06-11
Q2056 HCPCS Ciltacabtagene Car-pos T 2 2 — — $1,203,327.00 $1,224,531.00 $1,213,929.00 2025-06-11
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